What keeps you up at night, drives you crazy a lot of the time, and can you make you uncomfortable at times? It sounds like a crazy riddle, but if you suffer from eczema, all of this and more can be true for you. And considering that the National Eczema Association estimates that over 31 million Americans suffer from some form of eczema, this is a condition that we are very familiar with at Advanced Dermatology & Skin Surgery.
What is Eczema?
Eczema is a condition that causes itchy, inflamed, and red skin. Other symptoms include dry skin, rashes, scaly patches, blisters, and in severe cases skin infections. It is not contagious, so you cannot give it to someone else. Though the exact cause of eczema is unknown, those who suffer from it tend to have an over-reactive immune system that produces inflammation when triggered by internal or external factors. For most types of eczema, it is considered that a combination of genes and triggers is at fault. Researchers have found that some individuals have a gene mutation that causes them to have a problem creating filaggrin. This protein helps our bodies maintain the top layer of our skin as a protective barrier. If your skin barrier is compromised, it loses moisture, creating dryness, thus becoming more susceptible to infections.
Eczema is a condition that can be managed. There may be times when you will be asymptomatic. Then something will trigger your skin, causing a reaction, or, as it’s commonly referred to, a “flare-up.” Even though there is no cure, with treatment and being proactive, you can find relief.
There are seven different types of eczema:
- Atopic dermatitis – this is the most common type of eczema. Commonly seen in children, but it can affect you at any age. A lot of times, it is accompanied by hay fever and asthma. Adults typically see it on the insides of their knees and elbows.
- Contact dermatitis – so called because it comes about when you come into contact with something, causing an allergic reaction on your skin, leading to an itchy and sometimes painful rash. Typically seen on the hands and anywhere that your skin touches an irritant.
- Lichen Simplex Chronicus– more common in females, starts with a patch of itchy skin that can become thick and leathery from scratching. Triggers can be insect bites, dry skin, or tight clothing.
- Dyshidrotic eczema – causes tiny, extremely itchy blisters on the hands and feet. Skin can be flaky and scaly with redness. Triggers can be stress, wet hands/feet, and contact with metals such as cobalt and nickel.
- Nummular eczema – coin-shaped lesions that are itchy, sometimes oozing. The area around the lesion tends to be red, flaky, and inflamed. Triggers can be overly dry skin, trauma to the skin, or insect bites or scrapes.
- Seborrheic dermatitis – usually appears on spots on the skin where the oil-producing glands (sebaceous) are located, like the scalp, eyebrows, nose, and upper back. Spots are red, flaky, and oily. Triggers can include stress, hormonal changes, cold/dry weather.
- Stasis dermatitis – it affects the legs, mainly around the ankles. Symptoms include redness, scaling, itching, and pain. It is caused by poor circulation and the blood pooling in the lower leg.
It is possible to have more than one type of eczema on your body simultaneously. Consult with a Board-Certified Dermatologist so that your skin issues are properly diagnosed. Your Dermatologist will ask you some questions, and they might perform a small skin biopsy. The procedure involves numbing the area and removing a tiny amount of skin that gets looked at under a microscope.
What Treatments are Available?
A Board-Certified Dermatologist aims to reduce flare-ups, ease symptoms such as itch and pain, prevent your eczema from worsening, and lower your risk of infection.
To reduce itching and calm inflammation, your Provider might prescribe a corticosteroid cream or ointment to apply to your rash. Keep in mind that topical steroids should not be used more than twice a day. Antihistamines like hydroxyzine reduce itching by decreasing your body’s reaction to allergens. If you get an infection, your Provider will treat the infection with antibiotics.
At Advanced Dermatology & Skin Surgery, we also offer other treatments such as light therapy using the XTRAC® laser – it’s a light treatment that can safely and effectively treat eczema by exposing your body to ultraviolet (UV) light. For this to be effective, you will need 2 to 3 treatments per week or as determined by your Dermatologist.
Triggers and the Importance of Knowing Yours
Identifying your triggers can help you manage your eczema. These are things, whether internal or external, that cause inflammation on your skin, leading to redness, itching, flakiness, and other symptoms. Working with your Board-Certified Dermatologist can be helpful when trying to figure this out. Once you know your triggers, you can learn to avoid them, therefore reducing your flare-ups.
Common triggers include:
- Dry skin
- Everyday products and substances – includes things like hand and dish soap, laundry detergent, shampoo, bubble bath or body wash, surface cleaners, and disinfectants. Also, some natural liquids like lemon juice.
- Metals like nickel and cobalt – can be found on phones, keys, pens, jewelry, and coins.
- Cigarette smoke and fragrances
- Fabrics like wool and polyester
Managing Your Eczema in Your Everyday Life
- Moisturize frequently throughout the day with a fragrance-free ointment or cream that contains ceramides. Products over the counter that are great for daily use include CeraVe®, Aveeno®, Moisturel, Eucerin®, and Cetaphil®. Use ointments at night for additional protection.
- Use cleansers with low pH and soaps that are mild and gentle, such as Dove® or Olay®.
- Some people find soaking in a bath with oatmeal or baking soda calming. These can also be applied to the skin in the form of a paste.
- Take shorter baths and showers and use warm water, rather than hot.
- Dry yourself carefully. Gently pat your skin with a dry, soft towel and apply moisturizer while your skin is still damp. Avoid vigorous use of a washcloth when cleansing.
- Do not over-wash your hands, and make sure you dry them thoroughly.
- Use cotton gloves or cut your nails short to protect your skin from night-time scratching.
- Use wet wraps on your itchy skin.
- Wear soft, breathable, natural clothing next to your skin (like cotton).
- Emotional stress can trigger eczema, so meditation, acupuncture, or other treatments may help.
Depending on the season, you can do additional things to help manage your eczema. In the winter, you must contend with the cold and low humidity, causing dry skin, and in turn, making your eczema worse. When venturing outdoors, wear gloves, and avoid using winter clothing with wool or synthetics, which can irritate your skin. Stick to cotton and cotton blends. As temperatures drop, indoor heating goes up, be cautious as you crank up the heat as it can further dry the air in your house; using a humidifier can help.
In the summer, the heat and sweating can irritate your skin. It’s best to avoid activities that will make you hot and sweaty. Make sure the sunscreen you are using won’t irritate your skin. Stay hydrated, keep an extra bottle of cold water, and a washcloth with you to cool your skin. Keeping your gels and lotions refrigerated will make your skin feel good when it’s overheated. Wear loose-fitting, light cotton clothing. Cold showers can soothe your skin in the summer and so can swimming! The chlorine in the swimming pool can help your skin.
What About Bleach Baths?
The American Academy of Dermatology recommends considering a bleach bath to help prevent flares. A diluted-bleach bath decreases bacteria on the skin, keeps away related infections, and helps with inflammation. If you consider this option, do not submerge your head, and take a bleach bath no more than twice a week.
Consult with one of our Board-Certified Dermatologists to see if bleach bath therapy is something you would benefit from.
Keeping your symptoms under control is essential to staying healthy and comfortable. There may not be a cure for eczema, but there are treatments that help. Our Board-Certified Dermatologists will work with you to find what helps you, whether it’s one type of treatment or a combination of multiple. Reach out to one of our Board-Certified Dermatologists at one of our four locations, or you can schedule an appointment online.